| Formulary Chapter 2: Cardiovascular system - Full Chapter
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| Chapter Links... |
 NICE CG107: Hypertension in pregnancy: diagnosis and management |
| NICE CG108: Chronic heart failure in adults: management |
| NICE CG126: Stable angina: management |
| NICE CG127: Hypertension in adults: diagnosis and management |
| NICE CG180: Atrial fibrillation: management |
| NICE CG68: Stroke and transient ischaemic attack in over 16s: diagnosis and initial management |
| NICE NG185; Acute coronary syndromes |
| Details... |
| 02.06 |
Nitrates, calcium-channel blockers, and potassium-channel activators |
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Adrenaline / Epinephrine
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Formulary
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Atropine
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Formulary
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Bivalirudin (Angiox®)
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Formulary
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NICE CG94: Unstable angina and NSTEMI; early management
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Cangrelor
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Formulary
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Eptifibatide
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Formulary
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Nicorandil (Ikorel®)
(Tablets)
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Formulary
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Specialist initiation
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NICE CG126: Stable angina: management
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Ranolazine (Ranexa®)
(Tablets)
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Formulary
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Use current status at Place/Trust
Sandwell
 Supported by RICaD
RICaD Ranolazine-Sandwell only
Wolverhampton
Walsall
Dudley
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NICE CG126: Stable angina: management
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Tirofiban (Aggrastat®)
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Formulary
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| 02.06 |
Angina |
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| 02.06.01 |
Nitrates |
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Glyceryl Trinitrate Injection
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Formulary
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Secondary Care use only
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Glyceryl Trinitrate Sublingual tablets
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Formulary
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Glyceryl Trinitrate Transdermal Patches
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Formulary
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Glyceryl Trinitrate 400mcg/ dose Spray
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Formulary
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Glyceryl trinitrate buccal
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Formulary
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Isosorbide Dinitrate
(Oral)
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Formulary
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Isosorbide Mononitrate
(Modified Release Tablets)
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Formulary
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Brand prescribe modified release preparations
Follow Optimise Rx advice for new initiations
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Isosorbide Mononitrate
(Tablets)
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Formulary
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| 02.06.02 |
Calcium-channel blockers |
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Amlodipine
(Tablets)
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Formulary
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Diltiazem
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Formulary
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Felodipine
(Tablets)
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Formulary
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Lercanidipine
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Formulary
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Nicardipine (Cardene®)
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Formulary
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Nifedipine
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Formulary
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Nimodipine (Nimotop®)
(Tablets)
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Formulary
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Verapamil
(Tablets, MR tablets/capsules)
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Formulary
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Brand prescribe modified release preparations
Follow Optimise Rx advice for new initations
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UKMI Q&A: What is the evidence for verapamil for prevention of cluster headache?
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| 02.06.03 |
Other anitanginal drugs |
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Ivabradine
(Tablets)
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Formulary
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For use on the advice of a specialist in line with NICE TA267
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NICE CG126: Stable angina: management
NICE TA267: Ivabradine for treating chronic heart failure
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| 02.06.04 |
Peripheral vasodilators and related drugs |
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Naftidrofuryl Oxalate
(Capsules)
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Formulary
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NICE TA223: Cilostazol, naftidrofuryl oxalate, pentoxifylline and inositol nicotinate for the treatment of intermittent claudication in people with peripheral arterial disease
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| 02.06.04 |
Other preparations used in peripheral vascular disease |
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| .... |
| Non Formulary Items |
Amlodipine and Valsartan (Exforge®)
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Non Formulary
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Cilostazol (Pletal®)
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Non Formulary
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Inositol Nicotinate (Hexopal®)
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Non Formulary
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Isradipine (Prescal®)
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Non Formulary
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Lacidipine (Motens®)
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Non Formulary
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Moxisylyte (Opilon®)
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Non Formulary
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Naftidrofuryl Oxalate (Praxilene®)
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Non Formulary
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Nisoldipine (Syscor® MR)
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Non Formulary
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Oxerutins (Paroven®)
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Non Formulary
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Pentoxifylline (Trental®)
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Non Formulary
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Perhexiline
(Tablets)
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Non Formulary
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Perhexiline
(tablets)
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Non Formulary
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Key |
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Restricted Drug |
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Unlicensed |
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Link to adult BNF
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Link to children's BNF
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Link to SPCs
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Cytotoxic Drug |
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Controlled Drug |
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High Cost Medicine |
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Cancer Drugs Fund |
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NHS England |
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Homecare |
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ICB |
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Low carbon footprint |
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Medium carbon footprint |
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High carbon footprint |
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| Status |
Description |
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All Settings
Suitable for initiation, ongoing prescribing, and discontinuation in both primary and secondary care settings. They are generally familiar, frequently used therapies that can be started within their licensed indications without specialist oversight. |
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Specialist only
Designated for initiation, ongoing prescribing, monitoring, exclusively by a specialists either in a hospital or as part of a specialist service (to note this could be in a non-hospital setting). Primary care should neither start nor continue these treatments except as part of a specialist service. A specialist could be either a medical or non-medical prescriber. |
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Specialist advice
Prescribers in primary care should seek advice and a recommendation from a specialists prior to initiating a medicine. Once agreed with a specialist, medicines can be initiated, prescribed and monitored in primary care without a formal shared-care agreement. |
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Specialist initiation
Medicines in this category require a specialist to start therapy, titrate dosage, and assess initial efficacy or tolerability. Once stabilised, prescribing responsibility may transfer to primary care without the need for a formal shared-care agreement. |
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Shared care agreement
Prescribing responsibility can be shared across health settings and between specialists and GPs only when formal shared care arrangement has been made. For example, there may be extensive and complex monitoring requirements or significant safety concerns (note would need a national policy on this to define the criteria for requiring a formal SCA), this will be produced once nationally. |
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Do not prescribe
Not approved for routine prescribing in primary or secondary care. For example, because they are agents classified in the BNF as “not NHS” or “Drugs of Low Clinical Value”, or they are products on NICE’s “do not do” list or NHS England’s “should not routinely prescribe” list. |
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Self Care
Not for routine prescribed in primary or secondary care unless as part of care for a long term condition. Instead, patients should be encouraged to self care with support from community pharmacy. |
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Medicines which are suitable for initiation and maintenance prescribing by primary and secondary care clinicians. These medicines should be initiated and prescribed within their licensed indications |
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Amber Specialist Initiation: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing when appropriate. This may be supported by a RICaD, annotated within the formulary entry. |
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Amber Shared Care: Initiation and maintenance of prescribing by Specialists and transfer to Primary Care prescribing, in accordance with an ESCA, annotated within the formulary entry. |
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Amber Specialist Recommendation: Initiation and maintenance of prescribing in Primary Care following recommendation from a specialist. |
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Medicines for initiation and maintenance prescribing by Specialists (hospital or GPs with Special Interest) only |
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Positive NICE TA and /or awaiting local clarification on place in therapy; Please contact your Medicines Optimisation team for more information. |
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Non-formulary Medicines which APC/Trust DTC has actively reviewed and do not recommend for use. |
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